Drug interactions
Enalapril-hydrochlorothiazide + Fludrocortisone
Severity: Moderate
Enalapril-hydrochlorothiazide and Fludrocortisone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fludrocortisone has strong mineralocorticoid activity and promotes renal potassium loss, as does hydrochlorothiazide. Combined use can cause clinically relevant hypokalemia and hypomagnesemia, which may predispose to arrhythmias. Enalapril may partly offset potassium loss.
What this interaction means in plain words
Enalapril-hydrochlorothiazide and Fludrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Enalapril-hydrochlorothiazide belongs to Cardiovascular; Fludrocortisone belongs to Endocrine.
Why it happens
Additive renal potassium wasting through mineralocorticoid effect and thiazide-induced increase in distal sodium delivery.
What to do
Monitor serum potassium and magnesium regularly, particularly after starting or changing doses, and replace potassium as needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Enalapril-hydrochlorothiazide
- Aliskiren + Enalapril-hydrochlorothiazide Contraindicated
- Dofetilide + Enalapril-hydrochlorothiazide Contraindicated
- Enalapril-hydrochlorothiazide + Protein a column Contraindicated
- Enalapril-hydrochlorothiazide + Sacubitril / valsartan Contraindicated
- Amifostine + Enalapril-hydrochlorothiazide Major
- Amiloride + Enalapril-hydrochlorothiazide Major
Other interactions of Fludrocortisone
Frequently asked questions
Can I take Enalapril-hydrochlorothiazide with Fludrocortisone?
MediHelp rates the interaction as moderate. Enalapril-hydrochlorothiazide and Fludrocortisone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fludrocortisone has strong mineralocorticoid activity and promotes renal potassium loss, as does hydrochlorothiazide. Combined use can cause clinically relevant hypokalemia and hypomagnesemia, which may predispose to arrhythmias. Enalapril may partly offset potassium loss.
How serious is the interaction between Enalapril-hydrochlorothiazide and Fludrocortisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and magnesium regularly, particularly after starting or changing doses, and replace potassium as needed.
What other medicines interact with Enalapril-hydrochlorothiazide?
MediHelp also lists interactions of Enalapril-hydrochlorothiazide with, for example, Aliskiren, Dofetilide, Protein a column. The full list is on the Enalapril-hydrochlorothiazide page.
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